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Cellulite and Localized Fat
Localized fat deposits and cellulite, natural ways of storing fat, are problematic for a few reasons,
one being today’s aesthetic criteria that condemn it, the other being related to certain lifestyles
that encourage its development.
What is body fat?
A layer of fat occurs over most of the body. The primary functions of this fat layer is to provide
thermoregulation, protection against mechanical trauma, body contour and filling of body space.
Most importantly, this fat layer is a source of energy.
Adipose tissue (fat tissue) is loose connective tissue composed of adipocytes. It is technically
composed of roughly only 80% fat. Its main role is to store energy in the form of lipids, although
it also cushions and insulates the body. Subcutaneous fat is found just beneath the skin and
has no effect on one’s health as opposed to visceral fat which is found in the peritoneal cavity
packed between the organs (stomach, liver, intestines, kidneys, etc.) and is linked to metabolic
disturbances, such as an increased risk for cardiovascular diseases and type 2 diabetes. While
visceral fat can only be reduced by diet and exercise, subcutaneous fat is more resistant to diet
and exercise, and therefore it can be treated medically.
What is cellulite?
For years, many in the medical community have
argued that cellulite is merely fat and can only be
treated with diet and exercise. Yet, non-overweight,
physically active women have also been known
to show up at the spa or skin treatment center
with pleas for treatments or products to address
“dimpled” skin. The unfortunate truth is that 8090% of women will get cellulite some time after they reach puberty, and not all of these women
are considered overweight. In the female body, the uppermost layer of the subcutaneous tissue (or hypodermis) consists
of freestanding fat cell chambers (filled with fat cells), which are separated by vertical walls of
connective tissue called septa. The apex of these upright fat chambers is in the form of an arclike dome, which is weak and prone to collapse when undue pressure is applied. This pressure
could be the result of excess weight, fluid retention or lack of strength due to little or no exercise.
These larger chambers generate smaller compartments of fat cells (papillae adiposae) that cluster
tightly under the skin. This combination of freestanding fat cell chambers and compartmentalized
clusters of fat cells are the elements that create the change in appearance in the skin’s surface
known as cellulite.
Classification of cellulite:
Class 1: No spontaneous dimpling,
pinch test positive for dimpling
Class 2: Spontaneous dimpling
while standing
Class 3: Spontaneous dimpling
while standing and lying down
Cellulite in Females Vs. Males
Interestingly, when scientists compared the
structure of the hypodermis in female vs. male
patients, they found that the men had smaller
fat cell chambers with oblique septa; this latter
structural difference affords more strength
to the septa and enables them to withstand
collapsing under pressure. They also noted that
the smaller compartments of fat cells (papillae
adiposae) had the same structure in men and women. It is hypothesized that this difference in
structure of fat cell chambers may predispose women to cellulite more so than men. Interestingly,
men with more feminine characteristics tend to have fat cell chambers similar to women, thus
inferring that hormones also play a role in controlling this aspect of our structural diversity.
The precise cause of cellulite is most likely a combination of factors. We have already looked at
the structure of the hypodermis layer and explored differences that are inherent in women. One of
the causes of the rippling effect of cellulite is fluid retention in adipose tissue. The retained fluids
cause visible swelling of thighs, hips and abdomen, and the toxic wastes, contained in the fluids,
break down collagen and elastin fibers that help keep the skin smooth and firm.
With age, there is a decrease in the number of elastin and collagen fibers in cellulite tissue as
these structural proteins generally begin to stiffen and lose their flexibility. Loss of circulation
to an area – whether caused by lack of exercise, too much sitting, clogged arteries or nutrient
deficiency – can have a serious impact and also accelerate cellulite formation. In addition, many
commonly absorbed hormones can influence directly one’s capacity to store or get rid of cellulite
and fat deposits. It has been proven that our ability to store fat increases with age. It is important
to keep in mind that hormone levels are naturally modified with age, in particular during major
endocrine events such as puberty, pregnancy or menopause. Cellulite generally appears in areas
that have poor circulation; unfortunately, once it forms it slows circulation in the given area even
more. Engorging fat cells, accumulated fluids and toxins and poor circulation can exacerbate the
loss of firmness. All of these factors are believed to contribute to the formation of cellulite.
Most women have a combination of concerns
— extra adipose tissue and cellulite, which
originate respectively from the superficial plane
and the deep plane of the subcutaneous fat.
Local Fat Deposits
Another concern of men and women alike are local fat deposits, that
are resistant to diet and exercise. These deposits are contained in the
subcutaneous fat found just beneath the skin as opposed to visceral
fat which is found in the peritoneal cavity packed between various
organs (stomach, liver, intestines, kidneys, etc.). While subcutaneous
fat can be treated by liposuction, minimal-invasive and non-invasive
treatments, visceral fat can be eliminated only by diet and exercise.
Typical sub cutaneous localized fat deposits are in the lower abdomen,
outer thighs and love handles or areas of the body where cellulite
is also often present. Because these deposits tend to be resistant
to exercise and diet many people become discouraged when their
efforts fail to remove them. There is a growing market demand for treatment of these resistant fat
deposits and a great business opportunity for medical physicians.
How can we treat excess fat?
Liposuction is the most commonly performed aesthetic surgical procedure and the traditional
treatment for reduction of localized fat deposits. Liposuction is quite safe and surveys of patient
satisfaction indicate that people are usually pleased with the results. Liposuction requires
anaesthesia and is not selective to the fat cells; it involves surrounding tissues thus causing pain,
swelling bruising and a recovery period.
Despite its potential benefits, many patients understandably do not want surgery. Most patients
would prefer a non-invasive method for fat reduction and body contouring that is effective, yet
comfortable and safe, with minimal down-time.
Different technologies are employed for non-invasive fat and cellulite reduction, including
ultrasound, radiofrequency, infrared, vacuum, massage therapy and others.
Syneron-Candela offers a complete treatment for both cellulite and localized fat deposits combining
5 different technologies in 2 complementary devices.
• VelaShape® offers safe, efficient and virtually painless treatement to reduce body circumference
and cellulite. VelaShape provides dramatic results with minimal downtime or discomfort. This
product uses a combination of technologies (radiofrequency, infrared, vacuum and massage)
for a temporary reduction in the appearance of cellulite, and for a temporary reduction of thigh
circumference.
• UltraShape® uses focused ultrasound to safely deliver energy at a specific depth below the
skin surface and destroy fat cells without harming other structures, such as nerves, blood
vessels and connective tissue and with no discomfort. Results are immediate and long lasting.
References
1. Cellulite by Dr. Diana Howard, The International Dermal InstituteWorldwide
2. F. Nurnberger, G. Muller, So-called Cellulite: An Invented Disease, J. Dermatology, Surg., Oncol.
March 1978, vol. 4, No. 3, p. 221
2. M. Rosenbaum, et al, An Exploration and Investigation of the Morphology and Biochemistry of
Cellulite, PRS, June 1998, vol. 101,. 1934
4. K. Marenus, Cellulite Etiology, Dermatol. Surg. 1997, vol. 23, p. 1 177
5. W. Smith, Cellulite Treatments: Snake Oils or Skin Science, C&T Ingredient Resource Series,
AHAs and Cellulite Prod
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